Pregnancy and childbirth constitute a critical period in the recurrent cycles of maternal drug use. Both mother and newborn are at risk- the former for the effects of use on personal and maternal functioning,, and the latter for the consequences of perinatal drug exposure and parenting by a drug using mother, and the inadequacies foster care alternatives. By integrating maternal drug treatment with child health protection services, and providing individual case management of the infant and mother, we expect to improve outcomes for both and increase the likelihood of ma- intaining the child's custody within the family. In addition, by utilizing family social networks, and incorporating these into a program of family case management, hope to extend and deepen the effect of our interventions and provide both needed support for and greater inclusion of family members in decision- making and care of drug user and her children. In this project, we will recruit 180-200 maternal drug users giving birth at North Central Bronx Hospital for participation in a study comparing a program of routine case management with a family case management model. Both interventions will incorporate detoxification and longer term drug treatment, on-going peer support, and maternal and pediatric health services. Infant health and development outcomes as well as maternal drug use, parenting, and social functioning, will be compared under two interventions to identify both immediate and long-term consequences. The result of this trial will contribute to the development of programs and policies maternal drug users which combine their drug treatment with child protection and health care, and family support.